Provider Demographics
NPI:1588616676
Name:VOZZA, BRENDA M (MD)
Entity Type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:M
Last Name:VOZZA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:BRENDA
Other - Middle Name:M
Other - Last Name:VOZZA ZEID
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:300 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75601-6505
Mailing Address - Country:US
Mailing Address - Phone:903-315-2907
Mailing Address - Fax:033-152-9279
Practice Address - Street 1:300 N 3RD ST
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-6505
Practice Address - Country:US
Practice Address - Phone:903-315-2907
Practice Address - Fax:903-315-2927
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6399207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX031296902Medicaid
TX031296901Medicaid
TXG77364Medicare UPIN
TX031296901Medicaid